Orthopedic Emergencies

Question 1

Elbow approach

Answer 1

Swollen (yes/no)
Extend (yes/no)
Pain?
Supracondylar
Olecranon
Radial Head
Condyles

Question 2

Elbow xray

Answer 2

Anterior humeral line
Radio-capitellar line
posterior fat pad
sail sign (effusion pushing up fat pad)

Question 3

CRITOE

Answer 3

Capitellum
Radial Head
Internal condyle
Trochlea
Olecranon
External condyle

(2-4-6-8-10-12)

Question 4

Management elbow occult #

Answer 4

Back slab

f/u ortho 2-3 weeks

Question 5

Types of supracondylar #
Name of classifying system

How do you manage them?

Answer 5

Gartland classification
1: not displaced
2: displaced with an area of intact cortex
a= post. angulation, b = rotatory or straight displacement
3: completely displaced
a=no cortical contact, b=soft tissue gap

2 & 3 operative

Question 6

Natural hx of lateral condyle # elbow

Answer 6

gets pulled out if not treated surgically

Question 7

Monteggia # definition

treatment?

Answer 7

proximal 1/3 of ulna with radial head dislocation

need to reposition the ulna to get radial head into place

Question 8

Treatment of buckle #

Answer 8

removable splint X 3-4 weeks
f/u ortho optional (at end of tx if done)
no sports X 4-6 weeks

Question 9

Volar plate injuries

sign on exam
treatment
complication (1)

Answer 9

look for ecchymoses at joint line (DIP & PIP)
cast them in flexion, followed by extension-blocking splint
swan neck deformity